A heterogeneous group of 30 girls and 19 boys aged 16 to 19 years were recruited from across Scotland. They took part in 25 interviews which lasted 90 minutes at the location of their choice; each interview set was coupled with observed online activities.

The semi-structured interviews explored perceptions and experiences of different sources of sexual health information. This was followed by 20 minutes of unsupervised online activity where participants were asked to look for information they deemed relevant for two scenarios related to sexual health issues. Lastly, they were asked to feedback on the online activity.

Various practical and socio-cultural barriers to finding sexual health information and support online were revealed.

Practical barriers included not knowing where to start and problems filtering the sheer volume of content. There was a lack of awareness of specific, trustworthy online sources. Some thought school-based sexual health classes might have a role in helping them navigate the plethora of sites available.

Participants found it difficult to access relevant information about local services, particularly as most were part of a large organisation’s site which were not designed for intuitive online navigation. Some participants abandoned searches feeling frustrated at the ‘density of the content’. Barriers included too much text, tone of content and language that was difficult to understand.

A key socio-cultural barrier was the fear of being seen or heard to be accessing sexual health information especially if the content could be heard by people around them, in particular parents.

There was also a reticence to access audio-visual information in case the content was sexually explicit. Some were concerned that even ‘liking’ posts or interacting with sexual health organisations on social media might invite judgement from peers. A facility to interact privately with advisers was particularly valued.

A sexual health app was a definite ‘no’ for young people in case friends got hold of their phones; at least with internet browsers, they felt they could delete the search history.

The assumption that young people want to and can access sexual health information online is challenged somewhat by these findings.

There appears to be an ingrained stigma about engaging in seeking sexual health information online among adolescents.

Young people want to be able to find a source of information that is not only accessible but also has discreet audio-visual features that do not attract unwanted attention from people around them, a facility where they could have private messaging, and most important of all, without leaving a digital footprint of such activities.

The findings from this study challenge some assumptions we might have about how young people access sexual health information.

It also reminds us that people want the option of viewing content or seeking further information discreetly.

Young people are disproportionately affected by sexually transmitted infections and unplanned pregnancies. It is important for this group to have access to timely, accurate and non-judgemental information about sexual health that they can understand.

The authors conclude:

‘This study highlights both practical and socio-cultural challenges that can hinder young people in accessing sexual health information and services online.’

They recommend that these barriers should be addressed by promotion of accessible and authoritative information sources, sensitivity to concerns about audio-visual content, and provision of private sexual health messaging services.

Dr Richard Ma